This is a painful story to write.
A close friend of mine, in his 40’s, had a persistent light cough for many months. Finally, when he had an X-ray taken, it showed a large tumor on his lungs. He was diagnosed with stage 4 lung cancer. As a non-smoker and strapping, physically fit man, he was shocked, as you can imagine.
He went to his non-Boston-based medical practice, and he was told …
Clinical trial conflict of interest for doctors
by Michael Smith
Indoor tanning is associated with a 74% higher risk of melanoma, researchers said.
And, in a large case-control study, some forms of indoor tanning machines were associated with a four-fold increase in the risk of skin cancer, according to DeAnn Lazovich, PhD, of the University of Minnesota, and colleagues.
The risk rose in a dose-response fashion depending on years of use, hours of use, or number of sessions, Lazovich and …
Indoor tanning is associated with melanoma
by Charles Bankhead
There is still not enough evidence to show that radiation therapy for localized prostate cancer is better than surveillance, according to a report prepared for the Centers for Medicare and Medicaid Services (CMS).
Only retrospective analyses have compared irradiation with no treatment or no initial treatment. Data comparing the relative efficacy of different types of radiation therapy also are insufficient to permit definitive conclusions regarding efficacy, safety, and toxicity, …
Radiation or watchful waiting for prostate cancer treatment?
by Kristina Fiore
Claims of unintended benefits of statins appear to be largely unsubstantiated and known risks — including liver and renal problems and myopathy — confirmed, British researchers concluded based on findings from a large prospective open cohort study.
The study involving more than two million people, “largely confirmed other studies that reported no clear association between statins and risk of cancers,” Julia Hippisley-Cox, MD, and Carol Coupland, MD, of the …
Statins do not decrease the risk of many cancers
by John Gever
Easy access to CT colonoscopy may not reduce the number of conventional colonoscopies performed.
After the University of Wisconsin’s (UW) health system persuaded local insurers to cover the imaging-based screens in 2004, there was little sign that patients preferred them to standard endoscopic exams, according to Patrick Pfau, MD, the university’s director of clinical gastroenterology.
Mean quarterly counts of optical colonoscopies performed at UW rose from 1,104 in 2003 to …
Virtual colonoscopy access may not reduce lower endoscopy rates
by Kristina Fiore
Medical imaging for cancer patients and resulting costs have increased over the last decade, particularly in positron emission tomography (PET), researchers have found.
Annually, use of the diagnostic screen rose significantly between 1999 and 2006 — ranging from 36% in lung cancer to 54% in breast cancer, Kevin A. Schulman, MD, of Duke University, and colleagues reported in the April 29 Journal of the American Medical Association.
Imaging costs also …
Medical imaging is increasing in cancer patients
The heresy of one age becomes the orthodoxy of the next.
-Helen Keller
The patient returned to my clinic several years after her original thyroid cancer surgery. “The cancer blood test never went completely back to zero,” she told me. “We knew there was cancer in there somewhere. Finally, the new ultrasound machine found it! I guess it is time for more surgery!”
I guess. In my patient’s situation, the latest high resolution diagnostic …
Treating cancer needs to be an individual patient decision
by John Fauber
Paula Oertel’s brain tumor disappeared for nine years while she was on a drug not approved for her condition. The tumor returned when a move to a new home triggered a Medicare review — and subsequent denial of coverage for the experimental treatment.
Now Medicare officials have decided she will be allowed to go back on the drug.
“I am hoping …
Medicare reverses a brain tumor drug decision
by Todd Neale
The greater burden of colorectal cancer in the black community appears to be related to healthcare utilization, and not biology, researchers found.
Similar proportions of black and white patients had polyps or masses detected by flexible sigmoidoscopy, but black patients were less likely than whites to have the recommended follow-up colonoscopy (62.6% versus 72.4%), according to Adeyinka Laiyemo, MD, MPH, of Howard University in Washington, and colleagues.
After adjustment for …
Colorectal cancer in blacks is affected by healthcare utilization
by Michael Kirsch, MD
Does anyone out there know why President Obama underwent a virtual ‘colonscopy’ (VC) instead of a conventional colonoscopy earlier this year?
In my gastroenterology practice, we do not offer colon cancer screening to 48-year-old individuals, unless special risk factors are present. Of course, maintaining the president’s health is in the national interest, so I understand why professional screening guidelines might not apply to him. For …
President Obama should have had colonoscopy without sedation
by John Fauber
For nearly a decade, Paula Oertel’s brain tumor was kept at bay by a drug that was not approved to treat her condition. Then Oertel did something she never imagined would jeopardize her health.
She moved — less than 30 miles — from one county in Wisconsin to another.
That move triggered a review of her health insurance from Medicare, which eventually led to a loss of coverage, including …
Medicare denies a brain tumor drug after a patient moves
Originally published in MedPage Today
by Joyce Frieden, MedPage Today News Editor
Almost 40 years and 100 billion federal dollars have been invested in the “War On Cancer” since President Richard M. Nixon declared it, but the campaign is far from over, two researchers concluded this week in the Journal of the American Medical Association.
“These funds have been more than matched by …
Cancer deaths are improving, but a cure remains distant
Originally published in MedPage Today
by John Gever, MedPage Today Senior Editor
When the mainstream media report on cancer treatments, they seldom note that aggressive therapies may fail or cause severe side effects, researchers said.
Analyzing more than 400 articles about cancer in major newspapers and magazines, investigators at the University of Pennsylvania found that adverse outcomes or palliative care were hardly …
Cancer side effects are being ignored by the media
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Originally published in MedPage Today
by Crystal Phend
The ASCO Genitourinary Cancers Symposium met recently, just after the American Cancer Society updated its prostate cancer screening guidelines to emphasize shared decision making and Congress heard testimony over use of prostate specific antigen (PSA) in prostate cancer screening.
Now urology is no stranger to debate. Controversy continues on overdiagnosis, overtreatment, and other issues raised …
PSA for prostate cancer screening is likely to continue
Originally posted in MedPage Today
by Emily P. Walker, MedPage Today Washington Correspondent
A day after the American Cancer Society (ACS) released updated prostate cancer screening guidelines, the group’s chief medical officer was before Congress urging the government to fund research into alternative screening methods for prostate cancer.
Otis Brawley, MD, an oncologist and chief medical officer for the ACS, told the House Oversight …
PSA screening for prostate cancer debated in Congress
Last month I saw a 65 year-old woman with a mass in her kidney in clinic for follow up. She had recently transferred her medical care to our clinic after her insurance changed.
She came with a few medical problems including high blood pressure, tobacco use and arthritis — diseases which are the bread and butter of primary care medicine — but she also came with a history of a mass …
Why cancer screening is not a black or white decision
The American Cancer Society has designated this weekend “Suits and Sneakers Awareness Weekend,” as part of the annual Coaches vs. Cancer program that will feature well-dressed basketball coaches wearing “sneakers instead of dress shoes with their usual game attire during weekend games to demonstrate their support for the Society and the fight against cancer.” The idea is to encourage people to exercise and eat a healthy diet to reduce their …
How overly aggressive cancer awareness can backfire
I’ve been given permission to deliver the National Consortium of Breast Centers (NCBC) position statement. It does a far better job with a critique of the USPSTF Screening recommendations than I did when I shared my first thoughts. As the President for the NCBC, I want to acknowledge the work done on behalf of our organization by our Policy Chairpersons, Drs. John Bell and Barbara Rabinowitz, both of whom are …
by Abraham Verghese, MD
I can’t get over the incredible images generated by our latest CT scans and MRI’s. The details of organ anatomy and the 3D reconstructions they can do are just amazing. One side effect of getting such fine resolution, is that more and more we are stumbling onto abnormalities that we were not necessarily looking for–incidentalomas, we call them.
Sometimes the discovery is fortuitous and lifesaving. But often …
Balancing the risks and benefits of cancer screening is an individual decision
by Mark E. Klein, MD
“I think anytime you use science to kind of fundamentally change what people are used to, I think it’s a difficult thing to grapple with.” So spoke Ned Calonge, chair of the United States Preventive Services Task Force (USPSTF) in explaining the reaction to that group’s recommendation to radically alter their previous guidelines for breast cancer screening. Regrettably the incorrect application of science, as in …
Linking the USPSTF mammogram guidelines to their virtual colonoscopy recommendations
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